The objective of this application by the Division of Neonatal-Perinatal Medicine at Duke University is to participate in the Cooperative Multicenter Neonatal Research Network whose goal is to investigate treatment strategies in the care of the neonate through large multicenter cooperative trials. Although relatively small, the Division's enthusiasm for evidenced-based medicine and its work in developing translational research projects is evidenced by faculty participation and leadership roles in past and present projects, such as the NIH sponsored HIM study, surfactant trials, a recent nitric oxide (CINRGI) trial, and the head cooling protocol for perinatal asphyxia. In an effort to support our clinical and basic science efforts, the Division has established the Neonatal-Perinatal Research Institute (NPRI) that cuts across traditional departmental and specialty lines to encourage collaborative translational research with a neonatal- perinatal focus. The Division of Neonatal-Perinatal Medicine is highly committed to clinical research and is a recent recipient of the Dean's "Award for Translational Medicine". Further evidence of our commitment is illustrated by the Division's support for two faculty and one fellow working towards a master's in clinical research, offered by the Duke Clinical Research Institute. Realizing that a strong component of our research effort must deal with the social and economic aspects of our care, we have developed creative approaches to evaluating health care economics. These strategies have resulted in significant positive financial gain for the Duke Health System a Division of Neonatal Medicine. At Duke, the ensuing partnership between hospital and Division has lead to a strengthening of hospital financial health and a resultant substantial hospital supported research endowment to the Division's research institute (NPRI). Testing the tools, approaches and analytical methods developed at Duke across the Network may be of interest and allow for verification of our findings. The Research Triangle area of North Carolina is growing and as a result, the Duke Health Care network now includes 3 nurseries. The system as a whole includes 6000 deliveries (3200 at Duke), 842 ICN inborn admissions and an additional 324 transports available for Network studies. The Division houses a comprehensive multidisciplinary follow-up clinic that approaches the patient in a holistic fashion with attention to nutrition and with strong pulmonary and neurologic focus. The Clinic is well connected to and works collaboratively with community services.